Clinical Efficacy Observation Of Jianpi Shenshi Decoction In The Treatment Of Diarrhea-predominant Irritable Bowel Syndrome With Spleen Deficiency And Dampness-heat Syndrome

Objective: To observe the clinical efficacy of Jianpi Shenshi Decoction in the treatment of diarrhea-predominant irritable bowel syndrome,and to explore the efficacy of treating the syndrome with traditional Chinese medicine,the improvement of clinical symptoms,and the incidence of adverse reactions.Methods: A total of 70 patients who met the Rome IV diagnostic criteria of diarrhea-predominant irritable bowel syndrome were collected from Director Li Tianwang’s outpatient clinic from June 2019 to November 2020,and were randomly divided into treatment group and control group,each for35 cases.Patients in treatment group were treated with Doctor Li’s self-made prescription for invigorating spleen and dampness.Prescription: Dangshen10 g,Fuling 10 g,Stir-fried Ovate Atractylodes Root 15 g,Semen Coicis 20 g,Amomum Villosum 6g,Tangerine Peel 10 g,Radix Aucklandiae 10 g,Pulp of Fructus Mume 15 g,Fructus Chebulae 10 g,Pomegranate Rind 15 g,Dried Foxnut 10 g,Chinese Yam 15 g,Medicated Leaven 15 g,Atractylodes Rhizome10 g,Chicken’s gizzard-Membrane 10 g,Prepared Liauorice Root 6g,300 ml liquor per day,warm take twice equally,once at 9 am and 3 pm respectively.The patients in control group were given combination oral therapy with Yijunkang 2# tid,Compound Glutamine 2# tid,Trimebutine Maleate 2# tid and one bottle of Jianwei Xiaoshi Oral Liquid,the course of treatment was 2months for each group.Before and after treatment,the TCM Symptom Scale,IBS Quality of Life Scale(QOL scale),Hamilton Anxiety Scale and Hamilton Depression Scale were filled in respectively in the two groups.The biochemical indexes and the results of enteroscopy were recorded for the two groups before and after treatment.The total TCM Symptom Score,Single Symptom Score,IBS Quality of Life Score,Hamilton Anxiety Scale and Hamilton Depression Scale before and after treatment were statistically analyzed,the data and the scores between the two groups before and after treatment were observed and compared to evaluate whether there was any difference in efficacy and safety between the two groups.Results: 1.A total of 70 patients with diarrhea-predominant irritable bowel syndrome with spleen deficiency and dampness-heat syndrome were included in this study,among whom 69 cases were eventually completed,with34 cases in the treatment group,35 cases in the experimental group,1 case was dropout with the rate of 1.43%;2.Comparison before enrollment: The two groups had no statistically significant difference before treatment in terms of age,gender,and course of disease(P>0.05),indicating that the basic data was comparable in the two groups.There was no significant difference in the total score of TCM symptoms,IBS Quality of Life Scale,Hamilton Anxiety Scale,Hamilton Depression Scale before treatment between the two groups(P>0.05),suggesting that the two groups were comparable in severity of symptoms;3.Comparison of overall efficacy: At the end of the treatment course,the total effective rate was 91.20% in the treatment group,there were 13 cases clinically cured,8 cases showed apparent effect,10 cases achieved outcomes,while in the control group,there were 5 cases,7 cases and 16 cases respectively,the total effective rate reached80.00%.There was significant difference between the two groups(P < 0.05),indicating that Jianpi Shushi Decoction had better therapeutic effects than Yishikang,Compound Glutamine,Trimebutine Maleate and Jianwei Xiaoshi Oral Liquid in the treatment of diarrhea-predominant irritable bowel syndrome with spleen deficiency and dampness-heat syndrome;4.Comparison of total symptom scores: the difference in total TCM symptom scores between the two groups before and after treatment is statistically significant(P < 0.001),suggesting that the drug had good effect in treating the diarrhea-predominant irritable bowel syndrome with spleen deficiency and dampness-heat syndrome in the two groups;After treatment,there was statistically significant difference in total TCM symptom score between the two groups(P < 0.05),suggesting that the treatment group had better effect than the control group in treating this disease;5.Individual symptom scores after treatment: there were statistically significant differences in scores between the two groups(P<0.05),suggesting that the treatment group had better improvement in the clinical symptoms of diarrhea-predominant irritable bowel syndrome with spleen deficiency and dampness-heat syndrome compared with the control group;6.The quality of life score comparison: IBS group before and after treatment the treatment group QOL scale contrast differences statistically significant(P < 0.05)and control group in QOL scale group compared with no statistical significance(P > 0.05),the treatment group of drugs in improving the quality of life of patients with this disease have a certain effect and no obvious role in the control group drugs.After treatment,there were statistically significant differences between the two groups in QOL scale(P < 0.05),suggesting that drugs in the treatment group were better than drugs in the control group in improving the quality of life of patients with this disease;7.Hamilton Anxiety Scale and Hamilton Depression Scale after treatment: Before and after treatment,there were statistically significant differences between the two scale groups in the treatment group(P < 0.05),while there were no statistically significant differences between the two scale groups in the control group(P > 0.05),suggesting that the drugs in the treatment group had a certain effect on improving the mental and psychological state of patients with this disease,while the drugs in the control group had no significant effect in this respect The two scales had statistically significant differences between the two groups after treatment(P<0.05).It was suggested that Jianpi Shenshi Decoction was superior to the combined treatment with Yijunkang,Compound Glutamine,Trimebutine Maleate,and Jianwei Xiaoshi Oral Liquid in terms of improving mental and psychological symptoms of diarrhea-predominant irritable bowel syndrome with spleen deficiency and dampness-heat syndrome;8.Safety: subjects had no obvious adverse reactions in the two groups.There were no obvious abnormal changes in the routine biochemical tests and colonoscopy before and after treatment,it was suggested that the treatment plans of the two groups were safe;9.Recurrence rate: followed up 4 weeks after treatment,2 cases had recurrence in the treatment group,with recurrence rate of 5.88%,and 8 cases in the control group,with recurrence rate of 22.86%,which showed statistically significant difference(P < 0.05).It was suggested that Jianpi Shushi Decoction was superior to Yijunkang,Compound Glutamine,Trimebutine Maleate and Jianwei Xiaoshi Oral Liquid in the long-term effect;Conclusion: Jianpi Shushi Decoction can effectively improve the clinical symptoms of diarrhea-predominant irritable bowel syndrome with spleen deficiency and dampness-heat syndrome,which is better than combined treatment with Yijunkang,Compound Glutamine,Trimebutine Maleate and Jianwei Xiaoshi Oral Liquid and has good safety and long-term effect.